Predictors of sustained functional cure in hepatitis B envelope antigen‐negative patients achieving hepatitis B surface antigen seroclearance with interferon‐alpha–based therapy

• Published in: Journal of viral hepatitis Vol. 26; no. S1; pp. 32 - 41
• Main Authors: Li, Ming‐Hui, Yi, Wei, Zhang, Lu, Lu, Yao, Lu, Hui‐Hui, Shen, Ge, Wu, Shu‐Ling, Hao, Hong‐Xiao, Gao, Yuan‐Jiao, Chang, Min, Liu, Ru‐Yu, Hu, Lei‐Ping, Cao, Wei‐Hua, Chen, Qi‐Qi, Li, Jun‐Nan, Wan, Gang, Xie, Yao
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.07.2019
• Subjects: Antigens; chronic hepatitis B; functional cure; Hepatitis; Hepatitis B; Hepatitis B e antigen; hepatitis B e antigen negative; Hepatitis B surface antigen; hepatitis B surface antigen loss; Interferon; Patients; chronic hepatitis B; hepatitis B e antigen negative; functional cure; hepatitis B surface antigen loss; interferon
• ISSN: 1352-0504; 1365-2893; 1365-2893
• DOI: 10.1111/jvh.13151

Hepatitis B surface antigen (HBsAg) loss is considered a functional cure in chronic hepatitis B (CHB). However, the durability of HBsAg loss after stopping treatment remains unknown. This study aimed to assess the sustained functional cure achieved by interferon therapy in hepatitis B envelope antigen (HBeAg)‐negative CHB patients. In this prospective study, 176 HBeAg‐negative CHB patients with functional cure were enrolled for 12 weeks of cessation treatment, and treatment information and baseline data were collected. Hepatitis B virus (HBV) biomarkers and clinical biochemical indicators were evaluated every 3 months; liver imaging examinations were performed every 3‐6 months during the 48‐week follow‐up. The sustained functional cure was evaluated. After the 48‐week follow‐up, the sustained functional cure rate was 86.63%. The cumulative rates of HBsAg reversion and HBV DNA reversion were 12.79% and 2.33%, respectively. Consolidation treatment ≥ 12 weeks after HBsAg loss achieved a significantly higher rate of sustained functional cure and significantly lower rate of HBsAg reversion than consolidation treatment < 12 weeks (76.19% vs 90.00%, P = 0.022 and 23.81% vs 9.23%, P = 0.014, respectively). Patients with hepatitis B surface antibody (HBsAb) had higher rate of sustained functional cure than patients achieving HBsAg loss but without HBsAb (89.86% vs 73.53%, P = 0.012). Consolidation treatment ≥ 12 weeks (odds ratio [OR] 16.478; 95% confidence interval [CI], 2.135‐127.151; P = 0.007) and high HBsAb levels (OR 8.312; 95% CI, 1.824‐37.881; P = 0.006) were independent predictors of sustained functional cure. Results suggested that 12 weeks of consolidation therapy after HBsAg clearance and elevated HBsAb levels help to improve functional cure.